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1.
Artigo em Alemão | MEDLINE | ID: mdl-25971454

RESUMO

BACKGROUND: The International Health Regulations (IHR) 2005 were conformed to German law on July 20, 2007 and described in detail by the Implementing Act (IHR DG). According to these legal bases, "designated airports" must maintain special capacities for protection against health threats, and are also responsible for performing regular IHR exercises. OBJECTIVES: Representation of the optimization of established operational concepts of various professions to manage infectious biological threats without obstruction of international travel, and mediation of experience to IHR professionals. MATERIALS AND METHODS: An exercise based on the case scenario of a travel-related febrile illness was performed at Munich International Airport on November 11, 2013. Preparations took 6 months and the exercise itself lasted nearly 12 h. The follow-up lasted an additional 9 months. A qualitative and quantitative evaluation of the exercise was completed. RESULTS: From an Individual Medicine and Public Health perspective, modular work structures and risk communication functioned adequately. The medical examination of passengers was also well managed. Areas requiring further optimization included arrival/departure times of external actors, transport of the index patient to hospital and protective measures for individual participants. Overall, a defined biological threat scenario representing a double infection with two highly pathogenic germs was handled satisfactorily without affecting international air travel. CONCLUSIONS: Modular supply components are an effective and forward-looking means in protection against threats occurring at airports. Key success factors include sufficient staff mobility, immediate self-protection of actors involved, effective risk communication and a strong overall coordination and monitoring of the situation.


Assuntos
Medicina Aeroespacial/legislação & jurisprudência , Aviação/legislação & jurisprudência , Hospitais de Isolamento/legislação & jurisprudência , Direito Internacional , Isolamento de Pacientes/legislação & jurisprudência , Transporte de Pacientes/legislação & jurisprudência , Procedimentos Clínicos/legislação & jurisprudência , Alemanha , Saúde Global/legislação & jurisprudência , Humanos , Internacionalidade , Modelos Organizacionais , Isoladores de Pacientes/normas , Simulação de Paciente
2.
Gesundheitswesen ; 73(6): 369-88, 2011 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-21695661

RESUMO

In 2007, the German Central Committee against Tuberculosis (DZK) published recommendations for contact tracing that introduced the new interferon gamma release assays (IGRAs). Meanwhile, substantial progress has been made in documenting the utility of IGRAs. Because IGRAs are usually superior to the tuberculin skin test (TST) in detecting latent TB infection (LTBI) with respect to sensitivity and specificity in adult contact populations that are at least partially BCG vaccinated, it is now recommended that instead of two-step testing only IGRAs be used.[nl]As the literature does not yet provide sufficient data on the accuracy of IGRAs in children younger than 5 years, the TST remains the method of choice in that age group. To date, also, no clear body of data exists to substantiate better performance for IGRAs than for the TST in older children, thus in this age group using of either test is recommended. The new recommendations also underscore the importance of a diligent preselection of close contacts in order to achieve a high probability that positive test results represent recent infection and to thus increase the benefit of chemopreventive treatment for those identified as requiring it. In a third point of update, it is noted that re-testing of contacts individuals found positive for LTBI may produce a considerable number of false-negative results and should thus be avoided in case of documented exposure.


Assuntos
Busca de Comunicante/métodos , Testes de Liberação de Interferon-gama , Tuberculose Latente/diagnóstico , Tuberculose Latente/transmissão , Vacina BCG/administração & dosagem , Criança , Pré-Escolar , Alemanha , Humanos , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/transmissão , Valor Preditivo dos Testes , Fatores de Risco , Teste Tuberculínico
3.
Pneumologie ; 65(6): 359-78, 2011 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-21560113

RESUMO

In 2007, the German Central Committee against Tuberculosis (DZK) published recommendations for contact tracing that introduced the new interferon gamma release assays (IGRAs). Meanwhile, substantial progress has been made in documenting the utility of IGRAs. Because IGRAs are usually superior to the tuberculin skin test (TST) in detecting latent TB infection (LTBI) with respect to sensitivity and specificity in adult contact populations that are at least partially BCG vaccinated, it is now recommended that instead of two-step testing only IGRAs be used.[nl]As the literature does not yet provide sufficient data on the accuracy of IGRAs in children younger than 5 years, the TST remains the method of choice in that age group. To date, also, no clear body of data exists to substantiate better performance for IGRAs than for the TST in older children, thus in this age group using of either test is recommended. The new recommendations also underscore the importance of a diligent preselection of close contacts in order to achieve a high probability that positive test results represent recent infection and to thus increase the benefit of chemopreventive treatment for those identified as requiring it. In a third point of update, it is noted that re-testing of contacts individuals found positive for LTBI may produce a considerable number of false-negative results and should thus be avoided in case of documented exposure.


Assuntos
Busca de Comunicante/métodos , Testes de Liberação de Interferon-gama , Tuberculose/prevenção & controle , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/prevenção & controle , Infecções Oportunistas Relacionadas com a AIDS/transmissão , Adolescente , Adulto , Fatores Etários , Antituberculosos/administração & dosagem , Vacina BCG/administração & dosagem , Criança , Pré-Escolar , Alemanha , Humanos , Tuberculose Latente/diagnóstico , Valor Preditivo dos Testes , Fatores de Risco , Teste Tuberculínico , Tuberculose/diagnóstico , Tuberculose/transmissão , Adulto Jovem
4.
Emerg Infect Dis ; 6(5): 539-42, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-10998387

RESUMO

We describe two cases of Mycobacterium microti infection causing pulmonary tuberculosis (TB) in HIV-seronegative immunocompetent patients in Germany. The isolates were identified as M. microti of the llama and vole types, according to spoligotype patterns. Our data demonstrate that M. microti can cause severe pulmonary TB in immunocompetent patients.


Assuntos
Soronegatividade para HIV/imunologia , Mycobacterium/isolamento & purificação , Tuberculose Pulmonar/microbiologia , Antituberculosos/uso terapêutico , Alemanha , Humanos , Imunocompetência , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mycobacterium/classificação , Mycobacterium/efeitos dos fármacos , Radiografia , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/tratamento farmacológico
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